Splenic irradiation (SI) is a safe and effective treatment for symptomatic splenomegaly, according to a review of 27 studies involving 486 individuals.

The authors reviewed studies that looked at patient selection and optimal technique, SI efficacy, and SI toxicities. Among the results:

• Chronic lymphocytic leukemia and myeloproliferative disorders were the most common disorders treated.
• The most common regimen was 10Gy in 1Gy fractions over 2 weeks; 27% of patients received retreatment.
• Partial or complete response was obtained in 85% to 90% of treated patients; 30% were retreated within 6 to 12 months.
• There was no correlation between biologically equivalent dose of radiation therapy and response duration, pain relief, spleen reduction, or cytopenia improvement.
• Grade 3-4 toxicity occurred in 22% of courses; grade 5 toxicity arose in <1%.